Vol 29, No 3 (2024)
Research paper
Published online: 2024-06-19

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Current landscape of gastrointestinal radiation oncology in Spain: a multicenter real-life survey and comparison with key clinical guidelines

Ovidio Hernando-Requejo1, Maria Victoria Torres Olombrada2, Irene Alda Bravo3, Leire Arbea Moreno4, Fernando Lopez Campos5, Mercedes Lopez Gonzalez1, Margarita Martín Martín5, Virginia Morillo Mascias6, Carolina de la Pinta5
DOI: 10.5603/rpor.101096
Rep Pract Oncol Radiother 2024;29(3):340-347.


Background: The GI Tumors Workgroup, a division of the Spanish Society of Radiation Therapy, conducted a survey in December 2020 to assess the adherence of radiation oncologists in Spain to international guidelines for gastrointestinal tumors.

Materials and methods: Using Google Forms, we designed a survey covering treatments for esophageal, gastric, pancreatic, and rectal cancers.

Results: In esophageal cancer treatment, neoadjuvant chemoradiation was the standard in 76.7% of institutions. Radiation doses range from 41.1 to 50.4 Gy in conventional fractionation. Planning positron emission tomography-computed tomography (PET-CT) was performed in 83.3% of centers, and intensity-modulated radiation therapy/volumetric-arc radiation therapy (IMRT/VMAT) was the preferred technique in 86.7% of institutions.

For gastric cancer, 71.4% followed perioperative chemotherapy guidelines. In the case of adjuvant radiotherapy, the majority prescribed 45–50.4 Gy, and 82.1% used IMRT/VMAT for treatment.

For pancreas cancer, neoadjuvant chemotherapy followed by surgery in borderline resectable tumors and induction chemotherapy followed by radical radiotherapy for non-resectable tumors were the most frequent approaches. IMRT/VMAT was the primary technique.

Locally advanced rectal cancer treatment is mainly based on neoadjuvant radiotherapy in all institutions. The preferred radiation doses typically range from 45 to 50 Gy in conventional fractionation. IMRT/VMAT was standard in most Institutions.

Conclusions: Spain’s radiotherapy practices among respondents generally align with international guidelines for GI tumors highlighting Spain´s commitment to evidence-based medical practice.

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